POS1562-PARE CAN EDUCATION PROGRAMS REDUCE ANXIETY IN PATIENTS WITH RHEUMATOID ARTHRITIS?
Authors: S. Lezhenina, N. Shuvalova, E. Guryanova, N. Igoshina
Journal: Annals of the Rheumatic Diseases (2022)

Background Persistence of pain syndrome is accompanied by emotional changes and contributes to the formation of anxiety disorders in patients with rheumatoid arthritis (RA). Models of training patients with RA are aimed at developing the correct behavioral stereotype and improving the psychological status. To evaluate the effectiveness of these educational programs, it is required to study the impact of these programs on the level of anxiety in patients with RA. Objectives To assess the impact of education in an educational program in patients with RA on the level of anxiety. Methods The study was conducted in the Chuvash Republic, the city of Alatyr, from December to January 2020. 90 patients with RA of varying severity were examined. The inclusion criterion was a diagnosis of RA in accordance with the criteria of the European Antirheumatic League (EULAR) / ACR 2010. All patients were randomized into two groups: the main group (n=45), which, on the background of drug therapy (methotrexate at a dose of 7.5 to 15 mg/week and nimesulide 200 mg/week) was trained in the educational program: lectures and practical exercises. In the practical part, most of the time was devoted to the skills of self-control of the disease (taught how to self-assess swollen and painful joints). The training was carried out in two stages. The first stage (lecture-practical course) - twice a week for 1.5 hours, for two weeks, full-time education. The second stage (lecture course) - twice a week for 1.5 hours for two weeks, distance learning. In the control group (n=45), patients received the same treatment but were not trained in the educational program. Patients in these groups were representative by sex and age. All patients before and after completing the training program (after 1 month) were determined the level of situational and personal anxiety according to the Spielberger questionnaire modified by Yu.L. Khanina. The results obtained were interpreted: up to 30 points - a low level of anxiety, 31-45 corresponded to an average level, over 45 - a high level of anxiety. Statistical processing was carried out in the MS Office Excel package with the determination of average values (M), standard deviation. In each group, anxiety levels before and after training were compared using Student’s t-test for normally distributed data, otherwise Wilcoxon’s test. Differences were considered statistically significant at p&lt;0.05. Results Before training in the main group, the structure of personal anxiety was represented by a high level of 62.14 ± 4.46 points (83.0% of patients), while reactive anxiety was represented by average values of 39.24 ± 3.29 (62% of patients). 2% of respondents had a low level of personal anxiety, 5.2% of patients had low levels of reactive anxiety. Anxiety scores were about the same in the two groups. After training in the main group, the level of personal anxiety decreased in 41% of respondents (53.22±6.87 points), reactive anxiety decreased by more than 2 times in 27% of patients. The number of patients with low levels of both personal and reactive anxiety increased to 40% and 40.2%, respectively. The differences were statistically significant (p&lt;0.05). In the control group, the level of anxiety did not change statistically significantly. Conclusion Patients with RA who were trained in an educational program had a two-fold decrease in the level of personal anxiety and more than a two-fold decrease in the level of reactive anxiety, compared with patients who did not receive training. It is possible that the decrease in the level of anxiety in patients with RA occurred both due to a higher level of awareness of patients about this disease, and due to changes in the psycho-emotional state. Disclosure of Interests None declared